Trends of syphilis before, during, and after the COVID-19 pandemic in central India: A retrospective study

Syphilis is a sexually transmitted disease that varies in presentation according to the stage of the disease. Susceptibility to penicillin contributed to the near elimination of the disease during the 1990s to 2000 period. Recently, there have been reports of the re-emergence of syphilis from all parts of the world.

To study the clinical presentation and trends of syphilis.

A retrospective study was conducted from January 2013 to December 2024. All clinically and/or serologically diagnosed cases of syphilis were included in the study. Medical records of all the patients attending the sexually transmitted infection clinic were analyzed concerning age, sex, clinical presentation, and laboratory investigations. Statistical analysis was done using mean, median, and proportion.

A total of 260 cases with syphilis were enrolled. The male-to-female ratio was 5.53:1. The most common stage of presentation was latent syphilis (45.6%). The most common age group affected was 21-30 years. Out of the total cases, 2.7% of cases were pregnant females, 14.18% were human immunodeficiency virus (HIV) positive, and 95 cases were men who have sex with men cases. Only two cases of congenital syphilis were detected.

A resurgence of syphilis cases has been observed in the last 3 years, with latent syphilis contributing to the majority of cases. Possible factors attributed to this surge include promiscuous sexual behavior, HIV coinfection, male having sex with male, and early adolescent sexual exposure. The sudden rise in latent syphilis cases is a warning sign of resurgence in India, as it signifies the persistence of syphilis in the subclinical phase in the community.